Learning objectives

Neurosciences-2 module

TOTAL WEEKS-5

Central Curriculum Committee, Khyber Medical University

List of themes

Themes Duration in weeks

1 Facial palsy (face, 5th and 7th cranial nerves) 1

2 Neck swelling (thyroid, larynx, neck, muscles etc.) 1

3 Cleft palate (palate, tongue, pharynx) 1

4 Anosmia

5 Diplopia / blindness (2nd, 3rd, 4th, 6th cranial nerve / eye

ball / orbit)

7 days

6 Deafness (ear / 8th nerve) 3 days

General learning outcomes

At the end of this module, the 2nd year students will be able to:

1) Describe the structure of vertebrae, skull bones palate, pharynx, larynx, facial bones

and base of the skull

2) Describe the contents walls and boundaries of anterior and posterior triangles of the

neck

3) Describe the structure, relation, blood supply and venous drainage of thyroid

4) Describe the arteries, veins and nerves of the neck including cervical plexuses

5) Describe the nuclei, course, relations, and structures supplies by all cranial nerves

6) Describe the origin, course, relations and structures supplies by the arteries, veins

and lymphatics of head and neck

7) Describe the anatomy of all the muscles of facial expression and head and neck

8) Describe the structure and functions of eye, ears, nose and paranasal sinuses

9) Describe the development of different structures of organs of the head and neck

10) Identify the microscopic structure of salivary glands and tongue

11) Examine a standardized patient`s cranial nerves

12) Demonstrate perimetry and audiometry

specific learning objectives

Theme-1 (Facial palsy)

Subject Topic S. No Learning objectives

Gross anatomy Osteology of

mandible

Describe the gross features of adult

mandible.

Describe the bony features of

mandible

Name the joints formed by mandible

Name the attachment of muscles and

ligaments on mandible

Norma frontalis Describe the bony features of frontal

view of skull

Norma basalis Name the bones forming the base of

skull

Name the bony features

Identify the different foramina and

name the structures passing through

these foramina

Describe the attachment and relation

of base of skull

Describe the clinical importance

Norma lateralis Name the boundaries of temporal

fossa

Enumerate the contents of temporal

fossa

Describe the relations of temporal

fossa

Name the boundaries of

infratemporal fossa

Enlist the contents of fossa

Describe the relations of

Infratemporal fossa

Name the layers of scalp

Scalp and muscles

of facial expression

Describe the muscles of scalp

Name the neurovascular supply of

scalp

Describe the lymphatic drainage of

scalp

Name the fascial muscles along with

attachments, nerve supply and

actions

Muscles of

mastication

Enumerate the muscles od

mastication along with their

attachments, nerve supply and

actions

Blood supply and

lymphatic drainage

of face

Describe the blood supply and

lymphatic drainage of face portion

Temporomandibular

joint (TMJ)

Name the type of TMJ

Name the ligaments related with TMJ

Describe the relations of TMJ

Name the muscles causing

movements of TMJ

Name the neurovascular supply of

TMJ

Extra cranial course

of CN VII

Describe the extra cranial course of

CN VII along with its clinical

importance

Embryology Face development Discuss the five facial primordia

Describe the inter-maxillary segment

Describe the embryological defects of

face

Histology Parotid glands Identify the variety of gland according

to nature of its acinus

Discuss the capsular structure and its

extensions in the gland

Differentiate between the stroma and

parenchyma of parotid gland

Describe the ductal system of the

gland and its lining epithelium

Differentiate between the

intercalated and striated ducts in

intralobular parts of gland

Describe the detailed structure of

serous acinus

Discuss the location of stenson,s duct

and its structure

Discuss clinical conditions related

with parotid gland

Biochemistry Biotechnology Describe the indications and

procedure of Polymerase Chain

Reaction (PCR), Cloning and

Restriction fragment length

polymorphism (RFLP)

Purine Nucleotide

synthesis and

degradation

Describe the process of neucleotide

synthesis and degradation

Hyperuricemia- Describe the normal levels of serum

Gout Uric acid in the blood

Describe the mechanism of synthesis

of Uric acid from Purines

Describe the etiology, pathogenesis

and clinical features of Gout

Pyrimidine

Nucleotide

synthesis and

degradation

Describe the mechanisms of

Pyrimidines synthesis and

degradation

Salvage pathway of

nucleotide synthesis

Explain the salvage pathway of

Nucleotide synthesis

The structural basis

of cellular

information

Explain the structural basis of cellular

information

DNA, chromosomes,

discovery and

organization in

genome

Explain the structure, organization

and functions of Chromosomes, DNA

and genes

DNA replication Describe the process of DNA

replication

Transcription Describe the mechanism of

transcription

Protein synthesis Explain the mechanisms of protein

synthesis

Mutation Define mutation

DNA, damage and

repairs

Explain the mechanisms of DNA

damage and repair

Medicine Bell`s palsy Describe the clinical features and

management of Bell`s palsy

Skills and affective domain

Histology Submandibular and Identify the slide of submandibular

Sublingual Salivary

Gland

and sublingual salivary glands under

the microscope

Physiology Examination of Cranial nerves, V, VII

Examine the cranial nerves V & VII on

a standardized patient

Theme-2 (neck swelling)

Subject Topic S.

No

Learning objectives

Gross Anatomy Typical cervical

vertebra

Describe the bony features of typical

cervical vertebrae

Name the joints formed by typical

vertebrae

Describe the attachments

Atypical cervical

vertebra

Describe the bony features of atypical

cervical vertebrae

Name the joints formed by atypical

vertebrae

Describe the attachments

Hyoid bone Describe the bony features of hyoid bone

Describe the attachments of muscles and

ligaments with hyoid bone

Pterygopalatine

fossa

Name the boundaries of pterygopalatine

fossa

Enumerate the contents of

pterygopalatine fossa

Describe the relations of pterygopalatine

fossa

Deep fascia of neck Enumerate the layers of deep cervical

fascia

Draw and labelled diagram of transverse

section of neck showing deep cervical

fascia

Describe the layers of deep cervical fascia

along with its clinical importance

Larynx Name the paired and unpaired cartilages

of larynx

Enumerate the ligaments and membrane

of larynx

Describe the sensory and blood supply of

larynx

Enumerate the intrinsic and extrinsic

muscle of larynx along with its actions and

nerve supply

Describe the pyriform fossa

Ant. triangle of neck Enlist the subdivisions of anterior triangle

of neck

Describe the boundaries and contents of

submental triangle

Describe the boundaries and contents of

carotid triangle Describe the boundaries

and contents of digastric triangle Describe

the boundaries and contents of muscular

triangle

Post triangle of neck Enlist the subdivisions of posterior triangle

of neck

Describe the boundaries and contents of

occipital triangle

Describe the boundaries and contents of

supraclavicular triangle

Arteries of neck Describe the course, Distribution and

branches of main arteries of neck

veins of neck Describe the course, Draining and

tributaries of main veins of neck

cervical plexus and

nerves of neck

Describe the cervical plexus along with its

branches and distribution

Embryology Pharyngeal

apparatus

Describe the components of pharyngeal

apparatus.

Describe the development of pharyngeal

apparatus

Enlist the derivatives of the first

pharyngeal arch

Define the terms pharyngeal arch, pouch,

cleft and membrane

Enumerate the derivatives of the second

pharyngeal arch

Enumerate the derivatives of the 3rd

pharyngeal arch

Enumerate the derivatives of the 4th

pharyngeal arch

Enlist the derivatives of 1st ,2nd, 3rd and 4th

pharyngeal pouches

Describe the derivatives of pharyngeal,

grooves, and membranes

Discuss the arterial supply and innervation

of the pharyngeal arches

Describe the pharyngeal membranes

Discuss the branchial cyst, sinuses, and

fistula

Describe the 1st arch developmental

defects

Histology Thyroid gland Discuss the structural unit of thyroid gland

Identify the lining epithelium of follicular

cells

Discuss the formation and storage of

colloid in the lumen of follicular cells

Describe the location and structure of

parafollicular cells

Discuss the interfollicular connective tissue

ENT Lump in neck Approach to a patient with lump in the

neck

Skills and affective domain

Histology Thyroid gland Identify the slide of thyroid gland under

the microscope

Physiology Examination of Cranial nerves XI, XII

Examine a standardized patient for Cranial nerves XI, XII

Theme-3 (Anosmia)

Subject Topic S.

No

Learning objectives

Anatomy Nose and paranasal

sinuses

Describe the external features of nose

Describe the relations of nose with other

structures

Describe the nasal septum

Describe the lateral wall of nose

Name the neurovascular supply of nose

Describe the olfactory nerve

Describe the paranasal sinuses along with

its clinical importance

Embryology Development of

nose

Describe the development of nasal cavities

and paranasal air sinuses.

Describe the development of nasolacrimal

groove, duct, and sac

Enlist developmental defects of nose

Physiology Sense of Smell Describe olfactory membrane

Explain mechanism of excitation of the

olfactory cells.

Discuss Rapid Adaptation of Olfactory

Sensations.

Define threshold for smell

Describe transmission of smell signals into

the central nervous system

Describe primitive and newer olfactory

pathways into the central nervous system

Describe centrifugal control of activity in

the olfactory bulb by the central nervous

system.

ENT Sinusitis Describe the causes and clinical features of

acute and chronic sinusitis

Gross anatomy Tongue Describe the mucosa and muscles of

tongue along with its attachments, nerve

supply and actions

Salivary glands Name the salivary glands

Describe the location of each gland

Describe the relations of each gland

Name the nerve supply

Describe the drainage of salivary glands

along with its importance

Palate Name the bones forming the hard palate

Describe the soft palate along with its

muscles, attachments and nerve supply

Describe the relations of palate

Name the neurovascular supply of palate

Pharynx Enumerate the division of pharynx

Describe the nasopharynx with its clinical

significance

Describe the oropharynx with its clinical

significance

Describe the laryngopharynx with its

clinical significance

Enlist the muscles of pharynx with its

nerve supply and actions

Extra-cranial course

of CN IX, XXi, XII

Describe the extra cranial course of CN IX,

X, XI and XII

Embryology Tongue Describe the development of anterior 2/3

of the tongue

Discuss the role of the third pharyngeal

arch in tongue development.

Discuss the innervation, blood vessels, and

muscles of tongue.

Describe the development of papillae,

taste buds and salivary glands.

Describe the developmental anomalies of

tongue.

Palate Describe the development of primary and

secondary palate.

Discuss the developmental defects of lip

and primary, secondary palate

Histology Submandibular

glands

Identify the variety of gland according to

nature of its acinus.

Discuss the capsular structure and its

extensions in the gland

Differentiate between the stroma and

parenchyma of submandibular gland

Describe the ductal system of the gland

and its differences with parotid gland

Describe the detailed structure of serous

and mucous acinus

Discuss the formation of serous demilune

Discuss the opening of Wharton,s duct

Discuss different pathological conditions of

the gland

Sublingual glands Identify the variety of gland according to

its nature of acinus

Differentiate between the stroma and

parenchyma of sublingual gland

Describe the ductal system of the gland

and its lining epithelium

Describe the detailed structure of its

acinus

Discuss the opening of Bartholin ducts

Discuss different pathological conditions of

the gland

Physiology Sense of Taste Discuss primary sensations of taste

Explain threshold for taste

Describe the taste bud and its function

Describe mechanism of stimulation of

taste buds

Describe transmission of taste signals into

the central nervous system

Pediatric

surgery

Cleft palate Describe the pathogenesis, clinical

features and management of a patient

with cleft palate

Skills and affective domain

Histology Tongue Identify the slide of tongue under the

microscope

Physiology Examination of

Cranial nerves I, IX,

X

Examine a standardized patient for cranial

nerve I, IX, X examination (sense of smell,

taste, gag reflex)

Theme-4 (Diplopia)

Subject Topic S.

No

Learning objectives

Gross anatomy Bony orbit Name the bones forming the bony orbit

Identify the foramina, fissures, and fossae

associated with the orbit and what are the

structures transmitted through these

openings.

Name the contents of orbit

Eye ball Name the layers of eyeball

Describe the fibrous layer of eyeball

Describe the pigmented layers of eyeball

Describe the inner nervous layer of eyeball

Describe the chambers and of eyeball

Describe the secretion and drainage of

aqueous humor and vitrous humor

Describe the neurovascular supply of eye

Describe the intra and extraoccualr

muscles with their attachment, actions

and nerve supply

Extra cranial course

of CN III, IV, VI

Describe the course of optic, oculomotor,

trochlear and

abducent nerve with clinical importance

Embryology Development of eye Define lens placode and formation of

retina.

Describe the development of ciliary body,

iris, lens and choroid.

Discuss the formation of sclera, cornea,

sphincter and dilator pupillae

Discuss the development of virtreous body

and optic nerve

Describe developmental anomalies of eye

Histology Eye Enlist different histological layers of the

eye

Discuss retinal pigment epithelium(RPE) in

detail

Describe the structural details of rods

and cones and the supporting cells

Discuss structure of macula densa

Describe the histological layers of cornea

and retina

Physiology Physical Principles

of Optics

Describe refraction at interface between

two media.

Describe the physical principles of optics.

Apply refractive principles to lenses

Describe Focal Length of a Lens

Explain formation of image by convex

lenses

Explain how to measure refractive power

of a lens

Optics of The Eye Explain lens system of the eye.

Describe the concept of “Reduced” Eye.

Explain accommodation reflex.

Explain presbyopia

Describe that “depth of focus” of the lens

system increases with decreasing pupillary

diameter

Define visual acuity.

Explain the determination of distance of

an object from the eye- —“DEPTH

PERCEPTION”

Describe errors of refraction

Fluid System of The

Eye—Intraocular

Fluid

Describe the formation of aqueous humor

by the ciliary body

Describe the outflow of aqueous humor

from the eye

Describe Regulation of Intraocular

Pressure and Glaucoma

Anatomy and

Function of The

Structural Elements

of The Retina

Describe foveal region of the retina and its

importance in acute vision.

Discuss the functional parts of the Rods

and Cones.

Describe blood supply of the retina—the

central retinal artery and the choroid

Photochemistry of

Vision

Explain rhodopsin-retinal visual cycle and

excitation of the rods

Explain the role of vitamin A for formation

of rhodopsin.

Describe excitation of the rod when

rhodopsin is activated by light

Describe receptor potential, and

logarithmic relation of the receptor

potential to light intensity

Describe mechanism by which rhodopsin

decomposition decreases membrane

sodium conductance—the excitation

“cascade.”

Explain dark and light adaptation.

Color Vision Describe photochemistry of color vision by

the cones

Explain tricolor mechanism of color

detection

Explain Young-Helmholtz theory of color

vision.

Explain color blindness.

Neural Function of

The Retina

Describe different neuronal cell types and

their functions

Describe the visual pathway from the

cones to the ganglion cells

Discuss the retinal neurotransmitters.

Discuss retinal ganglion cells and their

respective fields

Describe lateral inhibition.

Explain excitation of ganglion cells.

Discuss on and off response of ganglion

cells.

Visual Pathways Discuss the function of the dorsal lateral

geniculate nucleus of the thalamus.

Describe organization and function of the

visual cortex

Describe primary visual cortex.

Describe secondary visual areas of the

cortex.

Describe two major pathways for analysis

of visual information: (1) the fast

“position” and “motion” pathway

and (2) the accurate color pathway

Describe neuronal patterns of stimulation

during analysis of the visual image

Discuss detection of color

Eye Movements and

Their Control

Describe muscular control of eye

movements.

Describe neural pathways for control of

eye movements.

Describe fixation movements of the eyes

Explain mechanism of involuntary locking

fixation—role of the superior colliculi.

Explain “Fusion” of the visual images

from the two eyes

Describe neural mechanism of stereopsis

for judging distances of visual objects

Autonomic control

of Accommodation

and pupillary

aperture

Describe autonomic nerves to the eyes

Describe control of accommodation

Describe control of pupillary diameter

Discuss Pupillary reflexes or reactions in

central nervous system disease.

Community

medicine

Prevention of

blindness

Describe the causative agents and

prevention of community blindness

Medicine Ocular nerves

palsies

Describe the clinical features and etiology

of 3, 4 and 6th nerve palsies

Ophthalmology blindness Approach a patient with unilateral and

bilateral blindness

Skills and affective domain

Histology Parotid Gland Identify the histological layers of parotid

gland under the microscope

Physiology Visual Acuity Examine a standardized patient for visual

acuity and errors of refraction

Perimetry Examine a standardized patient for visual

field function

Theme-6 (Deafness)

Subject Topic S.

No

Learning objectives

Gross anatomy External and middle

ear

Describe the auricle

Describe the external auditory meatus

with clinical importance

Name the neurovascular supply of external

ear

Name the boundaries of middle ear

Describe the contents of middle ear

Describe the auditory tube along with its

clinical importance

Inner ear Describe the bony labyrinth

Describe the membranous labyrinth

Describe the course of CN VIII along with

its clinical importance

Embryology Development of

ears

Describe the development of external and

middle ear

Explain the origin of internal ear along the

relationship of saccule, utricle, semi-

circular canals

Describe the development of cochlear

duct and organ of corti

Enlist the developmental anomalies of

external middle and internal ear

Physiology Tympanic

Membrane and

The Ossicular

system

Explain conduction of sound from the

tympanic membrane to the cochlea.

Describe “Impedance Matching” by the

Ossicular System.

Describe attenuation of sound by

contraction of the tensor tympani and

stapedius muscles.

Describe transmission of sound through

bone.

Cochlea Describe functional anatomy of the

cochlea

Describe basilar membrane and resonance

in the cochlea.

Describe transmission of sound waves in

the cochlea—“traveling wave”

Describe pattern of vibration of the basilar

membrane for different sound

frequencies.

Describe amplitude pattern of vibration of

the basilar membrane.

Describe function of the organ of corti

Describe Excitation of the Hair Cells

Discuss the “place” principle

Describe detection of changes in

loudness—the power law.

Describe threshold for hearing sound at

different frequencies.

Auditory Nervous

Pathways

Describe auditory pathway.

Explain the function of the cerebral cortex

in hearing.

Describe how to determine the direction

from which sounds come.

Describe transmission of centrifugal

signals from CNS to lower auditory centres

Describe different types of deafness.

Vestibular

Sensations and

Maintenance of

Describe the physiologic anatomy of

vestibular apparatus

Equilibrium

Describe function of the utricle and

saccule in the maintenance of static

equilibrium

Describe function of semi-circular ducts

Describe Neuronal Connections of the

Vestibular Apparatus

Describe Vestibular mechanism for

stabilizing the eyes

ENT Hearing loss Describe different clinical tests for hearing

loss

Describe the etiology and management of

conduction and sensorineural hearing loss

Skills and affective domain

Physiology Examination of

Cranial Nerves III, IV

and VI

Examine a standardized patient for

oculomotor, abducens and trochlear

nerves with an ophthalmoscope

Physiology Tuning fork test Examine a standardized patient for hearing

loss with tuning fork (Weber and Rinne`s

test)

Physiology Audiometry Examine a standardized patient for

functions of inner ear